ANAPLASTIC LARGE CELL LYMPHOMA, CANCER, GUMMY BEAR IMPLANTS, METASTATIC BREAST CANCER, METASTATIC BREAST CANCER

MY LEFT BOOB

Dr. Plastic didn’t like the look of my left fake boob any more than I did. The boob was angry. It had been an angry red for days and there was soreness underneath.

This was last week—Tuesday, April 23rd. Dr. Plastic is my fake boob guy.  

Examining my left fake boob, Dr. Plastic winced. 

Over the five years I’ve known him, Dr. Plastic’s hair has gone from gray-flecked black to white-flecked gray and his elastic face has become more elastic—winces: wincier, grimaces: grimacier, that thing he does when he moves all his facial features from the center of his face to the left: more exaggerated—squinched-up-ier. I hated to think the problem of my boobs, left and right, contributed to Dr. Plastic’s aging process, but I felt certain it had.

We began well, Dr. Plastic, my fake boobs, and I. For a while in 2013, I was his model patient. His nursing assistants told me so. 

I chose the new and improved “gummy bear” implants then—implants the consistency, not the shape (or, I assume, flavor) of a gummy bear candy. I healed quickly. The drains came out right away. The stitches dissolved like stitches should…

But the real breasts had been even—a matching set—and the fake boobs (as things settled, it became clear) were not. By 2014, though the implants were out-of-the-box equivalents, the fully healed left fake boob looked bigger. A “C” to the right side’s “C minus.” At a 2014 appointment, Dr. Plastic winced and grimaced and squinched and said, “Plastic surgery is not a perfect science. These things—these minor asymmetries— sometimes happen. The tissue removed during mastectomy, for example, might not have been completely equal.” 

Dr. Plastic said he could attempt minor surgery, to “shift things around,” but that would carry a risk of INFECTION. We did not want to risk infection. “Implants,” Dr. Plastic explained, do not have the ability to fight off infections. If we got an infection in there, among the implants… and if antibiotics couldn’t cure the infection, which they often can’t… then we’d have to take the implants out… and, because we’d have to wait a while to be sure every smidgeon of infection had been killed dead and done for…” and because of scar tissue, and because my healing ability had, by then, been compromised by chemo—we might have to reconcile ourselves to being… “Flat.” 

Possibly.

Flat.

For.

Ever.

In 2014, We did not want to risk INFECTION, did we? Dr. Plastic shrugged his shoulders. No, we did not. I shook my head.

The right fake boob—the smaller fake boob—took its revenge, in 2016, when it flipped over from back to front. 

Imagine one day you are exercising in your local gym, in a tight tank top. You bend over to pick up a workout bar and, as you begin to straighten, you feel a brief fluttering in your chest. But you are exercising, so you ignore the odd sensation. You’re trying to be tough. You lift the workout bar over your head, arms wide apart. You hold the bar there, counting one Mississippi, two Mississippi… and you glance in the mirror. That’s when you see that your right fake boob has gone flat as the underside of a tea kettle. 

End of gym session.

Of course, I took my newly flat right boob to see Dr. Plastic who said, “These things—implants flipping from back to front—sometimes happen.” He winced and grimaced and told me he had not had success manipulating implants back into their correct position. And the manipulation was said to be—squinched face here—extremely painful for the patient. He could remove and replace the offending little right boob, but that procedure presented the possibility of guess what? INFECTION. Dr. Plastic shrugged. We did not want INFECTION in and among the fake boobs, did we? I shook my head. 

Dr. Plastic suggested that, since the right fake boob flipped over once, it might flip over again—flip back into its proper position. And I could try to manipulate the boob myself. So, for a few months in 2016, I did try. I squeezed and scrunched my right boob like it was Dr. Plastic’s wincing, grimacing, squinching-up face. The right boob didn’t return to its proper position. Eventually, though, it relaxed somewhat against the contour of my chest wall and its flat edge, facing front, rounded slightly. That had to do.

Anaplastic…

?Half a paragraph from a typed letter with the words Anaplastic Large Cell Lymphoma highlighted in yellow and a yellow arrow pointing to the highlighted words.
Letter from Dr. Plastic

It was January 2019 when I got the form letter from Dr. Plastic’s office. The form letter said new research revealed that the “gummy bear” implants—the kind I had—recently became associated with a rare, potentially fatal, cancer of the immune system: anaplastic large cell lymphomaWhat? I could get cancer from the fake boobs I got after I had a double mastectomy because I had cancer?

When I was first diagnosed with breast cancer, in 2013, I was deluged with breast cancer brochures offering breast cancer paraphernalia. One catalog advertised t-shirts with breast cancer slogans like Stronger than you think! And Fight Like a Girl! And Straight Outta Chemo! An “o” or an “i” in every slogan was replaced with the pink ribbon symbol, just in case the t-shirt interpreter—the random man or woman on the street—didn’t get it. This is breast cancer we’re talking about here, the pink ribbons yelled. 

But the t-shirt that most tempted my purse back then was the one that read, HECK YES, they’re FAKE. THE REAL ONES tried to KILL me! (My daughter—thank you, Progeny—talked me out of buying that one.)

So, the real ones had tried to kill me in 2013. In January 2019, I learned, the fake ones might try to kill me all over again. Not yet, though. I didn’t have the symptoms of anaplastic large cell lymphoma—breast swelling, pain—when I received Dr. Plastic’s form letter in January…

I didn’t have the symptoms of anaplastic large cell lymphoma until…

Two weeks ago? Two weeks ago, I woke up with a pain under my left fake boob. The next day, I felt a little more pain there. The day after that, a little more. And the boob was red. 

Dr. Dear, my oncologist, prescribed an antibiotic when I saw her on chemo Friday. She took a picture of my boob and sent it to Dr. Plastic. Dr. Plastic’s office called on Monday. Dr. Plastic wanted to see me on Tuesday, April 23rd.

Which is when Dr. Plastic examined my angry red fake left boob and winced. Then he backed a few steps away, crossed his arms, grimaced, squinched, and said, “It doesn’t look like anaplastic large cell lymphedema. You would have much more swelling.” He winced again. “It could be an… infection.”

Why INFECTION when it’s a distant possibility; infection when it’s a bright red boob staring you in the face? I pulled the eggplant-colored, fake-luxurious, complicated-closing examination gown over my chest and crossed my own arms. “What do you suggest?” I asked.

“First,” (with his lips squinched over to the left again), “we can try a different antibiotic. A broader spectrum drug. And wait a few days. If that doesn’t work, we might have to put you in the hospital. To try the heavy hitters—the IV antibiotics.” Wince. Grimace.

Dreamboat was in the examining room too. Until that moment, I’d been doing what I usually do, now, with Dreamboat in a doctor’s office: tune him out. 

(Do you know how hard it can be for a fifty-nine-year-old woman to focus on her own needs—even if she has a terminal disease—when her husband, or, worse, her child, is in the room? It took me the first two years in Cancerland to stop worrying whether Dreamboat, accompanying me to a doctor’s appointment—to every doctor’s appointment—was bored, or embarrassed, or feeling ignored. Not that Dreamboat had any idea I was thinking about him in my doctor’s offices. Do you know how hard it is for a sixty-nine-year-old man to understand that all the women he’s ever known have worked to help make his life fit him as neatly as it does? Not too long ago, I asked Dreamboat this question. He looked at me with utter, only-endearing-because-I-love-him, bewilderment.)  

But there he was in Dr. Plastic’s office with me last Tuesday, and when our eyes met, he was wearing that relaxed-jaw, open-eyed, smooth-foreheaded look that I read as, Anything you need, baby. I turned back to Dr. Plastic. “Is there a scenario in which we skip the ‘different antibiotic’ and go directly to the hospital? For the heavy-hitting IV antibiotics?” 

Have I mentioned that Dr. Plastic is one of my favorite doctors? I’ll tell you why he is: over the past five years, Dr. Plastic, whenever I’ve walked into his office, has always had the latest information on my case in his head. He knew when I had my first cancer recurrence; my first radiation therapy; my second recurrence; my second radiation; ports placed and removed. 

And, on Tuesday, April 23rd, he was fully aware that I now have Metastatic Breast Cancer and not a lot of time. If I was going to have an infection that could render me flat, I would most likely be flat for the rest of my life. I did not want that. I wanted this infection out of here.

So, he winced, and he grimaced, and his eyebrows shot up. “Yes,” he said. “That’s a good idea.”

A good idea. Ah, fuck. Why is it, I wondered, that even with Dr. Plastic, I’m the one coming up with the good ideas?

“Right,” Dreamboat said, and he stood up. He was in super-supportive mode, ready to go.

Emergency

My right arm with IV and PICC lines accessed for blood draws out and medications in.
My right arm

“The hospital has a new policy,” Dr. Plastic told us before we left his office. “I’ll call ahead, but you have to get admitted through the ER.”

Dreamboat and I went home to pack a few hospital-stay necessities: laptop, meds list, yoga pants (for underneath the “gown”). An hour after we left Dr. Plastic, we were in the ER. The staff had Dr. Plastic’s call-ahead info, so in I went. An orderly took us to Room 8 where I put on the hospital gown—cotton, drab, unflattering; lay down on the gurney—ready to take me somewhere else, eventually, since one cannot remain in Emergency forever; and watched my nurse walk in. It was Nurse Hehe, whom I could not forget from a previous ER visit. I had been writhing in pain… asking for morphine… taking shallow breaths so my lungs wouldn’t shift my ribs, my chest, my shoulder, while I waited for Nurse Hehe to establish an IV. “Shoot,” she said then. “Well, hehe, I just broke your vein.”

This time, Tuesday, we hadn’t got to the IV issue yet. 

“Well, hello,” Nurse Hehe said. “May I see the… uh… hehe.”

“Breast,” I said.

🖤

In the next few days—health permitting—I’ll have more to say about the three days I spent in the hospital last week. Questions, questions, questions. When you’re in the hospital, they ask you a lot of them.

Please watch for my next blog post. Most importantly—sign up to:

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3 thoughts on “MY LEFT BOOB

  1. Oh, my sweet friend. I didn’t know the half of it even when you were going through it. I hope you know I am still what I try to be, your helpful, not-demanding, loving friend. I love you so much!

  2. OMG. I am just getting caught up on this. I had not read this before. Some of the other posts now make more sense. I’m speechless. And, since you know me, that is something. Thank you for your honesty and you willingness to share and describe.

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